BACKGROUND:Airway anastomosis complications continue to be a source of morbidity for lung transplant recipients. METHODS:This study analyzes incidence, treatment, and follow-up of airway anastomotic complications occurring in 127 consecutive lung transplant airway anastomoses (77 single lung and 25 bilateral sequential lung). Complications were categorized as stenosis (11), granulation tissue (8), infection (7), bronchomalacia (5), or dehiscence (3). Follow-up after treatment ranged from 6 months to 4 years. RESULTS:Nineteen airway anastomosis complications (15.0%) occurred in 18 patients. Telescoping the airway anastomosis reduced the complication rate to 12 of 97 (12.4%), compared with 7 of 30 (23.3%) for omental wrapping, (p = 0.15). Complications developed in 13 of 77 single-lung airway anastomoses (16.9%) versus 6 of 50 bilateral sequential lung recipients (12.0%). Treatment consisted of stenting (9 airway anastomoses), bronchodilation (8), laser debridement (4), rigid bronchoscopic debridement (2), operative revision (2), and growth factor application (2). There was no difference in actuarial survival between patients with or without airway anastomosis complications (p = 1.0). CONCLUSIONS:Airway anastomosis complications can be successfully managed in the immediate or late postoperative period with good outcome up to 4 years after intervention.

译文

背景:气管吻合并发症仍然是肺移植接受者发病的来源。
方法:本研究分析了127例连续的肺移植气道吻合术(77例单肺和25例双侧序贯肺)发生的气道吻合并发症的发生率,治疗和随访情况。并发症分为狭窄(11),肉芽组织(8),感染(7),支气管软化(5)或裂开(3)。治疗后的随访时间为6个月至4年。
结果:18例患者发生了19例气道吻合并发症(15.0%)。伸缩气管吻合术使并发症发生率降低至97例中的12例(12.4%),而网膜包裹术的并发症发生率为30例中的7例(23.3%)(p = 0.15)。 77例单肺气道吻合中有13例发生了并发症(占16.9%),而50例双侧连续肺接受者中有6例发生了并发症(占12.0%)。治疗包括支架置入术(9例气道吻合术),支气管扩张术(8例),激光清创术(4例),硬支气管镜清创术(2例),手术翻修术(2例)和生长因子的应用(2例)。有或没有气道吻合并发症的患者之间的精算生存率无差异(p = 1.0)。
结论:气道吻合并发症可在术后即刻或晚期成功治疗,干预后长达4年的效果良好。

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